Abstract
BACKGROUND: With the introduction of electronic cigarettes, reports of nicotine intoxication due to ingestion of large amounts of liquid nicotine have increased. This report presents a rare case of cardiac arrest due to nicotine intoxication that was successfully treated with appropriate respiratory and circulatory support. CASE PRESENTATION: A 55-year-old man ingested 600 mg of liquid nicotine and developed sinus bradycardia followed by asystole. Appropriate and prompt resuscitation led to the return of spontaneous circulation. He was admitted to the intensive care unit and discharged 24 days later without any medical sequelae of nicotine intoxication. CONCLUSION: Ingestion of a large amount of liquid nicotine, as in this case, can result in lethal bradycardia followed by cardiac arrest. Prompt basic life support by paramedic produced good neurological outcomes. Emergency physicians should be aware of the symptoms and appropriate treatment of severe nicotine intoxication.